Cloud Computing – the logistic fundament of Future Networked Care

Patient centric care models are more and more superseding provider determined structures and hospital based care.  There is evidence for associations between structural capabilities of health care providers and performance. In order to run distributed patient centric care models and thus improving the performance of health care systems successfully a patient centric distributed computing strategy needs to be available which supports key criteria such as trustworthyness (safe, secure, resilient), mobility, flexibility, value for money. 

 

Since 2009 the UK government has publicly stated their support for a public sector Cloud in the UK as one means to streamline services and to make them more cost efficient and effective. Especially in health care an upgrade of the existing information communication strategies and technologies in inevitable to make use of the innovations at the front end such as smart tags in order to integrate “objects” into medical data networks in an approach to embrace current activities in international 'Internet of Things' activities or artificial organs such as smart Insulin pumps which have the capability to interact with patients but require the appropriate IT infrastructure to function properly.

 

Although clearly defined needs and demands can be demonstrated throughout health care organisations on a global scale the current economical climate is adverse with very little hope that budget constraints could ease in the near future. 

 

 

We are suggesting a concept, which aims to reduce investment and capital costs within health care organisations and to improve the quality of care by replacing hospital and other health care provider "processes" (servers, software, etc.) by services which will only be paid for actually used up resources either as a pay as you go model or a flat rate. Service Oriented Architectures will be used to find and utilise Cloud-based resources. In order to only use appropriate and trustworthy resources the concept of service Level Agreements (SLAs) will be introduced. Service level agreements will enable users to identify their preferred service providers by benchmarking attributes and desired criteria.

 

Cloud-based “hardware and software as a service” models will also provide the stage for cross domain integration of multimodal data from different sources and will provide a boost for the further spread of Electronic Health Records which displays an important political target for the UK, the US and other European governments. The implementation of more dynamic IT structures will certainly help to shift the point of care further into the periphery, thereby giving patience more choice regarding the provision of care. In the future care in the UK will not only be delivered by local health care providers but patients will have the choice to “consume” any kind of service from health care providers not only in the UK but anywhere in Europe.

 

This approach will also empower patients as they will be able to monitor the use of their personal information, which has been a longstanding demand by pressure groups.

 

These scenarios might seem futuristic but the trends are clearly recognizable and there can be no doubt that the technical requirements have already been met and boundaries are to be pushed further by service providers at all levels. In the future we will se an increase in speed, bandwidth, growth of glass fiber and wireless networks, a rapidly growing number of novel services on the web. Interoperability will not be achieved by a static middleware on the local network but will be provided by a third party as a web based service. More front end devices will be introduce to the market and there will be no need any more for complex integration processes on a local level. The emerging “Internet of Things” will revolutionise health care and other areas in public services and IPv6 is a typical example for a technology in waiting to provide additional support for the next generation IT strategy.

 

Also, governance issues have already been addressed by policy makers. Apart from political initiatives on national and European level novel international standards such as ISO/IEC 80001 have been agreed and are support to come into effect by the end of 2010 / beginning 2011 in order to protect more sophisticated medical data networks. ISO / IEC 80001 will provide an international standard for the application of risk management for IT-networks incorporating medical devices. It will especially address the issue how medical devices should be connected to IT networks to achieve desired interoperability without compromising the organization in terms of the key properties safety, effectiveness and security.

 

The governance components within Service Oriented Architectures (SOA’s) as integrated part of any cloud approach will play an important role in order to safeguard and guarantee important standards such as legislation, national and international guidelines, etc.

 

Midterm we expect a significant reduction in costs, a much higher level of (real time) integration and an increased level of flexibility in terms of the delivery of care as a direct outcome of the introduction of latest computing strategies. This will improve the quality of care and will pay tribute to the deep societal changes, which lay ahead of us.

 

 

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